Overview

A bone marrow transplant is a procedure that infuses healthy blood-forming stem cells into your body to replace bone marrow that’s not producing enough healthy blood cells. A bone marrow transplant is also called a stem cell transplant.

You might need a bone marrow transplant if your bone marrow stops working and does not produce enough healthy blood cells.

Bone marrow transplants may use cells from your own body (autologous transplant) or from a donor (allogeneic transplant).

Why it’s done

A bone marrow transplant may be used to:

• Safely allow treatment with high doses of chemotherapy or radiation by replacing or rescuing the bone marrow damaged by the treatment
• Replace bone marrow that’s not working properly with new stem cells
• Provide new stem cells, which can help kill cancer cells directly

Bone marrow transplants can benefit people with a variety of both cancerous and noncancerous diseases, including:

• Acute leukemia
• Adrenoleukodystrophy
• Aplastic anemia
• Bone marrow failure syndromes
• Chronic leukemia
• Hemoglobinopathies
• Hodgkin’s lymphoma
• Immune deficiencies
• Inborn errors of metabolism
• Multiple myeloma
• Myelodysplastic syndromes
• Neuroblastoma
• Non-Hodgkin’s lymphoma
• Plasma cell disorders
• POEMS syndrome
• Primary amyloidosis

Risks

A bone marrow transplant can pose numerous risks. Some people experience minimal problems with a bone marrow transplant, while others can have serious complications that require treatment or hospitalization. Sometimes complications are life-threatening.

Your risks depend on many factors, including the disease or condition that caused you to need a transplant, the type of transplant, your age and your overall health.

Possible complications from a bone marrow transplant include:

• Graft-versus-host disease (a complication of allogeneic transplant only)
• Stem cell (graft) failure
• Organ damage
• Infections
• Cataracts
• Infertility
• New cancers
• Death

Your health care provider can explain your risk of complications from a bone marrow transplant. Together you can weigh the risks and benefits to decide whether a bone marrow transplant is right for you.

Graft-versus-host disease: A potential risk when stem cells come from donors

If you receive a transplant that uses stem cells from a donor (allogeneic transplant), you may be at risk of developing graft-versus-host disease (GVHD). This condition occurs when the donor stem cells that make up your new immune system see your body’s tissues and organs as something foreign and attack them.

GVHD may happen at any time after your transplant. Many people who have an allogeneic transplant get GVHD at some point. The risk of GVHD is greater if the stem cells come from an unrelated donor. But GVHD can happen to anyone who gets a bone marrow transplant from a donor.

There are two kinds of GVHD: acute and chronic. Acute GVHD usually happens during the first months after your transplant. It typically affects your skin, digestive tract or liver. Chronic GVHD typically develops later and can affect many organs.

Chronic GVHD signs and symptoms include:

• Joint or muscle pain
• Shortness of breath
• Persistent cough
• Vision changes, such as dry eyes
• Skin changes, including scarring under the skin or skin stiffness
• Rash
• Yellowing of the skin and the whites of your eyes
• Dry mouth
• Mouth sores
• Diarrhea
• Nausea
• Vomiting